Bundled Payments Bundled Payment Basics A payment that
Bundled Payments
Bundled Payment Basics • A payment that provides a single amount of money for treatment by one or more providers during an episode of care • Bundled payments pay for services delivered across a certain episode of care instead of paying for each service associated with a medical issue separately
Bundled Payment Basics Physician Paymen t Hospital Radiologist Surgeon
Bundled Payments for Care Improvement Advanced • Five-year voluntary bundled payment model created by the Center for Medicare and Medicaid Innovation (CMMI) that started on Oct. 1, 2018 and ends Dec. 31, 2023 • Builds on the original BPCI model that concluded in October 2018 and qualifies as an Advanced APM • Retrospective payment that is tied to quality measure performance • Includes some level of downside financial risk
Tips for BCPI-A Participation • Decide if you will participate with a convener and determine the contract terms • Ensure collaboration with hospital partners since Quality measures are hospital-focused • Ensure robust practice transformation efforts to prepare for acceptance of downside risk in model year 1 • Collaborate with high quality post-acute care providers
Tips for BCPI-A Participation ü Ensure accurate attribution for your practice’s physicians ü Determine whether you meet the Medicare patient or payment threshold in order to receive the Advanced APM 5 percent bonus payment ü Determine whether your practice participates in other CMMI models that overlap with BPCI-A
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